The present invention relates to the irrigation of wounds, and more particularly pertains to a device and method that enables a user to quickly, safely, and economically flush a wound with large volumes of irrigant.
In the medical profession lacerations, cuts, abrasions, puncture wounds, and the like are commonly irrigated to remove foreign debris such as road particles, dirt, bacteria, and other contaminants which could predispose to infection. Removal of these contaminants as well as blood which continually emanates from the wound and surrounding tissue is also required to provide the treating medical personnel a clear view of underlying tissue and other vital structures affected by the injury during the exploratory phase of treatment. Wound cleansing is again required prior to wound closure to avoid future medical complications caused by wound contamination.
A number of different devices and associated methods of wound irrigation have been in common use by medical personnel in clinics and emergency rooms as well as in the field. A syringe is commonly employed to direct liquid irrigant at the wound site to thereby impact the wound and mechanically dislodge undesired bacteria and foreign matter from the wound surface and surrounding tissue.
Medical personnel have the option of simply resorting to the use of a syringe and hypodermic needle combination. While the use of such a combination enables a stream of irrigant to be precisely aimed, the technique suffers from a number of shortcomings. Bloody irrigant reflecting off of the patient may contaminate the surrounding area and may pass infection to the irrigator or to other individuals in the immediate vicinity. Moreover, use of sharp instruments always poses the risk of injury, both to the patient as well as to personnel handling the needles, the latter further running the risk of contracting a disease the patient may be infected with. Additionally, in order to expedite the filling process, it is necessary to remove the hypodermic needle each time the syringe is to be refilled.
Another method of wound irrigation utilizes a device which offers several safety advantages over the syringe and needle combination. This irrigation device eliminates the use of a hypodermic needle and minimizes the possibility of disease transmission through rebounding irrigation spray by incorporating a splashback shield as described in U.S. Pat. No. 4,769,003 to Stamler which is incorporated herein by reference. A generally bell-shaped splashback shield which is removably attached to a hypodermic syringe functions to prevent potentially contaminated irrigation fluid from ricocheting off of the wound back towards the irrigator or other nearby personnel. Thus reflected fluids will be restrained by the shield, rather than splash onto and infect surrounding personnel. The shield incorporates an integral, thin-walled, hollow tubule which is capable of engaging a Luer-lock syringe tip. By virtue of the smaller diameter of the tubule relative to the syringe, exiting irrigation fluid forms a narrow irrigation stream which travels down the central longitudinal axis of the shield to impact the wound. While this device provides several safety advantages to the attending medical personnel, repetitive wound irrigation still remains a laborious task as the splashback shield must be removed in order to enable the syringe to be refilled. Similar to the previously described method of wound irrigation, repetitive irrigations require painstaking manipulation of the irrigation device to refill the syringe in preparation for each subsequent irrigation.
Many medical authorities suggest that all wounds require a minimum of 250 cc's of irrigation fluid to ensure proper cleansing of the injured area and surrounding tissue. Following this principle, large, heavily contaminated wounds require even larger volumes of irrigation. To accomplish this with common syringes capable of containing 10-20 cc's of fluid, multiple irrigations are required. Unfortunately the devices described above require the removal of either a hypodermic needle or splashback shield prior to each refilling of the syringe for subsequent irrigations. This functional requirement is both time consuming and adds undesirable complication to methods of wound irrigation utilizing these devices.
Wound irrigation devices are available wherein the above-described refilling problems are addressed. Such devices provide a syringe that is linked to an IV bag via a tube, usually 6' long. A valve fitted to the syringe allows irrigant from the IV bag to be drawn into the syringe upon extension of the plunger and expelled upon compression of the plunger. A spring is usually employed to assist in extending the plunger and a splashshield may be fitted to the syringe.
A number of shortcomings nonetheless become apparent upon using such devices, all a direct result of the saline solution being supplied from an IV bag. Because both the syringe as well as the 6' of tubing extending to the IV bag are initially empty, the system must first be primed with irrigant solution which requires the repeated extension and retractions of the plunger before a wound can be irrigated. Another disadvantage of this method of wound irrigation results from the length of flexible tubing suspended between the syringe and the IV bag containing the irrigant solution . It will be appreciated that the length of flexible tubing, extending from the IV bag to the syringe limits the user's range of motion during wound irrigation and is awkwardly present in the injured area. When the IV bag is located in close proximity to the irrigation site, the excess length of tubing becomes a potential distraction to the irrigator. As the irrigator moves relative to patient and as the syringe is repositioned about the wound site, attention must be given to any excess length of tubing to ensure that it remains clear of the treatment area. Furthermore, the length of tubing through which the irrigant must be drawn each time the syringe is filled also poses a substantial resistance to flow which not only requires a substantial effort to be expended but significantly retards the rate of flow and thereby slows down the whole process. Increasing the force provided by an assist spring is of limited value as such force must then be overcome when the plunger is compressed. Finally, because an IV bag cannot re resealed once accessed, its entire contents must be used or discarded. The need for only a few hundred cc's of irrigant would therefore result in a substantial amount of waste. Saline solution supplied in IV bags is also more expensive than when supplied in bottles.
Thus, there exists a need for a wound irrigation device that enables substantial volumes of irrigant solution to be directed at a wound as quickly as possible with minimal effort, inconvenience, and expense.